耳鸣的深部脑刺激:现状与未来展望。

Deep brain stimulation in tinnitus: current and future perspectives.

作者信息

Smit J V, Janssen M L F, Schulze H, Jahanshahi A, Van Overbeeke J J, Temel Y, Stokroos R J

机构信息

Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.

Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.

出版信息

Brain Res. 2015 May 22;1608:51-65. doi: 10.1016/j.brainres.2015.02.050. Epub 2015 Mar 7.

Abstract

Chronic tinnitus, also known as ringing in the ears, affects up to 15% of the adults and causes a serious socio-economic burden. At present, there is no treatment available which substantially reduces the perception of this phantom sound. In the past few years, preclinical and clinical studies have unraveled central mechanisms involved in the pathophysiology of tinnitus, replacing the classical periphery-based hypothesis. In subcortical auditory and non-auditory regions, increased spontaneous activity, neuronal bursting and synchrony were found. When reaching the auditory cortex, these neuronal alterations become perceptually relevant and consequently are perceived as phantom sound. A therapy with a potential to counteract deeply located pathological activity is deep brain stimulation, which has already been demonstrated to be effective in neurological diseases such as Parkinson's disease. In this review, several brain targets are discussed as possible targets for deep brain stimulation in tinnitus. The potential applicability of this treatment in tinnitus is discussed with examples from the preclinical field and clinical case studies.

摘要

慢性耳鸣,也称为耳鸣,影响着多达15%的成年人,并造成严重的社会经济负担。目前,尚无实质性降低这种幻听感知的治疗方法。在过去几年中,临床前和临床研究揭示了耳鸣病理生理学中涉及的中枢机制,取代了经典的基于外周的假说。在皮层下听觉和非听觉区域,发现了自发活动增加、神经元爆发和同步性增强。当这些神经元改变到达听觉皮层时,就会在感知上变得相关,从而被感知为幻听。一种有可能对抗深部病理性活动的治疗方法是深部脑刺激,这已被证明在帕金森病等神经系统疾病中有效。在这篇综述中,讨论了几个脑靶点作为耳鸣深部脑刺激的可能靶点。通过临床前领域的实例和临床病例研究,讨论了这种治疗方法在耳鸣中的潜在适用性。

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